Cardiovascular disease is a leading cause of death in women, accounting for about 35 percent of deaths in women worldwide. Eating a healthy diet low in saturated fats and high omega-3 fatty acids such as the Mediterranean diet can help prevent or reduce the risk of cardiovascular disease.

Most of the studies looking into the benefits of the Mediterranean diet primarily enrolled male participants, however, and current dietary guidelines do not make sex-specific recommendations.

Following a Mediterranean diet lowered women’s risk of cardiovascular disease by 24 percent, they found, and the risk of death from any cause by 23 percent.

To see if the Mediterranean diet was equally beneficial for women, a team of researchers from Australia and the U.K. analyzed data from 16 studies that recruited more than 720,000 women. “It is possible that preventive measures such as the Mediterranean diet have different effects in women compared to men,” they said in a statement.

The 16 studies included in the analysis were done between 2003 and 2021, mainly in the U.S. and Europe. The participants were 18 years old or older and did not have cardiovascular disease when they enrolled in the studies. They were followed for an average of 12.5 years.

Consuming a Mediterranean-type diet lowered women’s risk of cardiovascular disease by 24 percent, they found, and the risk of death from any cause by 23 percent. It also lowered the risk of coronary heart disease by 25 percent among the women who followed the diet most closely, compared to those who followed it the least stringently.

There are a number of reasons for the cardiovascular benefits of the Mediterranean diet. It is rich in fruits and vegetables which provide antioxidants, polyphenols, nitrates and features the benefits of olive oil with its omega-3 fatty acids. Antioxidants help reduce the inflammation associated with cardiovascular disease and help protect the gut microbiome. The fiber-rich and low-glycemic foods that are part of the Mediterranean diet likely also contribute to its cardioprotective effects.

Excluding each study one at a time from the data analysis did not significantly change the reduction in cardiovascular disease and mortality risk associated with the Mediterranean diet, a finding that provided even more evidence supporting the idea that the diet is beneficial for women, though the exact mechanisms for the sex-specific effects of the Mediterranean diet remain unclear, the researchers said.

The University of Sydney researchers note that the studies included in the analysis were observational and relied on a self-reported food questionnaire rather than an objective measure. Different statistical methods to account for cardiovascular risk factors were also used among the various studies.

Female-specific cardiovascular risk factors, such as early menopause, preeclampsia or gestational diabetes, or other risk factors that mostly affect women, such as systemic lupus, should be the subject of future studies, the researchers said, along with the diet’s effects on women’s risk of stroke.

The study is published in Heart.